“Is It Possible To De-Calcify A Heart Valve Without Repairing Or Replacing It?” Asks Gwen

I just received an interesting question from Gwen about the treatment of calcified heart valves.

Gwen writes, “Hi Adam – I was diagnosed with a murmur 12 years ago when I was 49 years old. It’s gotten worse and I’m told that I need surgery. My cardiologist said that the valve has severe aortic stenosis and the valve is calcified. I’m curious to know… Is it ever possible for the surgeons to “de-calcify” the valve without having to repair of replace the valve or its leaflets?”

Calcified Bicuspid Aortic Heart Valve
Calcified Aortic Heart Valve (Aortic Stenosis)

To provide Gwen an expert response, I contacted Doctor Junaid Khan, the Director of Cardiovascular Services at Alta Bates Summit Medical Center. As you may have seen, Dr. Khan and Alta Bates have hosted several educational seminars for patients in Northern California.

In his response, Dr. Khan noted:

The short answer to Gwen’s question is no. There is no current technology to de-calcify a valve. There are several “gimmicks” that patients find on the web. Some of these gimmicks reference chelation therapy. However, none of these approaches have been scientifically validated.


Dr. Junaid Khan, MD

Dr. Khan went on to address the growing use of aortic valve repair for patients as an alternative to aortic valve replacement.

Aortic valve repair is on the rise for calcified heart valves — although, this surgical technique is not used to the extent of mitral valve repair. The technique is generally reserved for patients with aortic insufficiency with normal leaflets and just dilatation. The theory and hope is that an aortic valve repair will have greater longevity than a bioprosthetic valve. However, there is not a consensus yet on techniques for repair — or its validity.  The real problem is the inability to dynamically check the repair during surgery — like you can with a mitral repair. Also, the lack of a subvalvular support struture (like the mitral) limits the types of repair that can be done. The skeptics believe, you are just turning severe aortic regurgitation into mild aortic stenosis which is better tolerated and will hopefully last longer than a bioprostethic valve.

Thanks to Gwen for her question and a special thanks to Dr. Junaid Khan for sharing his clinical expertise with our community. To learn more about Dr. Khan, click here.

Keep on tickin!
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Adam Pick
Written by Adam Pick

Adam Pick is a patient, author of The Patient's Guide To Heart Valve Surgery and the founder of HeartValveSurgery.com.

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  • Joseph

    Believe me. I know that cardaic surgery will induce fear in anyone. It’s scary. But the alternative is an altered life style, or worse. I was dianosed with aortic stenosis when I was 52 years of age. Mild, became moderate, then severe, then critical. All over an 11 year period. I was 63 years of age and in great shape. I love to play tennis. One day, while chasing a shot into the corner, down I went. I was only out for about 5 seconds. But my buddies told me that I was out cold. That’s when I knew I was in over time. I stopped playing tennis and sat on my butt. I took up the guitar. It was killing me to not be able to get out on the court. So, I researched looking for the best Doctor in the world to save my life. I found Doctor Craig Smith at Columbia Presbyterian Hospital in NYC. He did an AVR on my in July, 2011. I was back on the court in 8 weeks hitting shots as well as I ever did prior to the surgery. Today, 17 months after surgery, I play 6 day’s a week, 2-3 hours everyday, both singles and doubles. My Cardiologist tells me the valve sounds great. I owe my life to Dr. Smith. What a Doctor. What a great guy. God Blesses this man everyday to do such great things for people whom would otherwise be in the ground. I’m one of the lucky ones. It takes courage. But courage is being scared to death, but you saddle up anyway. Go see Dr. Smith. Tell him Joseph sent you. Good Luck.

  • Steve

    Thank you Joseph for sharing your story and that last sentence: ‘But courage is being scared to death, but you saddle up anyway.’ That’s where I am at…surgery on the 31st for mvp and mod/severe regurg…I can’t wait to be on the other side and enjoying my life and kids.

  • Joseph

    Dear Steve,

    You will be GREAT! And when you wake up, your Life and your Children will be there waiting for you. Be a Warrior. A Marine. Kick Ass!!!!

  • Audrey M. Parker

    Dear Adam, Since having my Aortic Valve Replacement a year ago I have a concern around keeping my heart healthy. For instance are there any alternative supplements – herbs, vitamins, minerals that would help or maybe avoid?
    The last thing I want is to cause my new valve to calcify.
    I would be grateful for any information.
    Regards,
    Audrey M.Parker.

  • Diane

    Your words are encouraging. I am a 60 year old female, and I AM SCARED to death.
    But knowing how well you are doing is encouraging since, I , too, love to play tennis.
    My operation is still not scheduled, but I was told March 2013, which is coming up soon!
    I have read the guide and hope the Surgeon will be experienced in this type of surgery.
    I live in Ottawa, Ontario, Canada, and we have the University of Ottawa Heart Institute.
    Its also one of the best in the world, so, lets pray I survive!

  • Joseph

    Dear Diane,

    You will survive. And you will play tennis again. WILL IT to be so! As they wheeled me into the OR I was singing a hymm to My LORD GOD. I fet the presence of Jesus walking along side my bed. When I entered the OR I was immediately surrounded with 4 beautiful surgical nurses. We joked, and we laughed. I asked the anesthesiologist to make sure he didn’t lose me, and to positively make sure that I didn’t wake up with “Pump Head.” We laughed, the next thing I remember was waking up in ICU with a gorgeous African American nurse looking down at me saying, “Joseph, the surgical team said you did great. My name is Kiesha, and I will be taking care of you.” I was on my feet in 6 hours, sitting in a chair. walking in 8 hours. Up a flight of stairs on the second day. It’s a piece of cake. Don’t worry. Be Bold, and Bold things will come. It’s not that bad. Just make sure you have the RIGHT surgeon. Give yourself every chance to win this fight . . . . . . I’m here if you need me, Be Blessed, Joseph

  • Diane

    Thanks for your reply. It does encourage me.

    Diane

  • Bill

    I had aortic stenosis which took some time to diagnose. The treadmill and MRI tests were positive, and finally the echocardiogram test told the story, since you can actually see what is going on. I had a bovine AVR in April 2012 and everything went perfect. Out of the hospital in 5 days. 8 months later I feel pretty good, like 90%. Also had 2 bypasses which may not last the 20 years that the valve will. I take L-Ariginine and L-Citrullene supplements(in addiditon to the prescribed heard medication) to help build up the Nitric Oxide that is said to prevent and reverse plaque. My experience at Kaiser Permanented in Santa Clara has been excellent and I highly recommend the Cardioligy Deptarment, led by my surgeon Dr. Hon Lee.

  • Joseph

    Dear Bill,

    I read your post referencing the supplements that you take to reduce plague buildup. However, what is the HEARD medication that you also mention in that sentence in parenthesis? What is HEARD medication? New to me. Thank you, Joseph

  • Rick

    I just met with my surgeon to schedule my avr.
    He informed me that I have a bicuspid valve as well and my aorta is weakened putting me at a higher risk of an aortic aneurysm, so he wants to replace the weakened section of the aorta at the same time. I wasn’t too concerned about having the avr but now am much more apprehensive as I have very little symptoms and worry about being worse off afterwards, if I survive.

  • Ann

    Two years ago, age 59, I had an AVR due to a stenotic bicuspid valve. At the time,
    I didn’t know such thing existed…… I went online, found Adam’s book, and it was a huge
    help, as the staff doesn’t fully prepare you for the recovery process. (although I had a wonderful surgeon).. I know I would have been calling someone every day thinking something was wrong! My only problem until recently is a fast heart rate. Before surgery, it was around 60 and steady.
    Unfortunately, I started having symptoms again, and the valve has developed scar tissue and closing again.My bovine valve did not last 20 years, just two! There are no explanations, but I did have a tooth infection right after surgery and had to get the tooth
    extracted. Has anyone had any experience with infections that could have possibly caused the biological valve to do this? I will have a second surgery soon, but the doctors seem stumped on whether to use another bovine, or go mechanical.

  • Joseph

    Dear Ann,

    I read your Post. I am so, so sorry to hear of this News. You mentioned an infection followed by a tooth extraction. Did you pre-medicate? WE, all of us, have to pre-mediacte if there is going to be Blood during any mouth procedure, including but not limited to Deep Cleaning. (Prophylaxis)

    In my case, I had a tooth procedure done when I was 52 years of age. I found out subsequently that it was a procedure I did NOT need. I sued the dentist and recovered. But I believe it was that procedure that started my BV valve to deteriorate. I watched it go from Mild to Critical in 10 years. At 62, I ended up in the OR. A word of caution to all of us. Be mindful of your dental health. Many of the infections that are oral in nature CAN, and WILL affect the heart. I will be praying for you, and ALL will be well. Be Bold. Joseph

  • Ann

    Dear Joseph,
    Thank you so much for your reply. You are helping so many people, and using your experience for the good of others. Although I have a great support group here in Texas, I don’t know of anyone who has been through this surgery, except for my dad who is still doing well 8 years after his porcine valve replacement.
    I do believe the tooth infection, which began while still in the hospital, was a contributing factor,. I didn’t feel well enough to go to my dentist, but did begin antibiotics for a while, then had the tooth extracted a month later. It was a root-canaled tooth that we had been
    trying to save for 25 years, and I wish I had taken care of it before the surgery. There is a lot of information about root canals, and to be cautious. The Dr. Mercola website and holistic dentist websites are good to read.
    My doctors don’t believe this is the case, but I am just searching for an explanation as to why my bovine valve failed in less than 2 years, before my redo operation. (I will saddle up, too!)
    Prayers for you too!!
    Ann

  • Bill

    HI Bill again. This is to correct a typo where I referred to heard medication, but I meant heart medication. I was prescribed Losartin and Metropolol to control blood pressure and heart rate.

    Also, I was started on Coumadin since I had some A-Fib in the hospital. I requested heart monitor after about a month of Coumadin to determine if I still needed to continue taking Coumadin and suffer the negative side effects. After a month of the heart monitor and no A-Fib detected, the doctor relented and stopped the Coumadin. Hoever, he says there is still a risk and if it was up to him, I would be on Coumadin indefinitely. The heart monitor relied on me to detect A-Fib and press a record button, whcih I did a few times but could never be sure I was having A-Fib, and the recording results were negative. What is really needed is a heart monitor with the smarts to recognize A-Fib automatically, record it , and alert the patient. If anyone has knows of such a device, please let me know.

  • Bill

    Dear Ann,

    I too have had several root canals, and crowns, without antibiotics over my lifetime. I have had a relatively healthy lifestyle so I was surprised at my Aortic valve calcification. I had a bovine AVR in April so your experience is very relevant to me. My question to you is: what exactly was the failure mechanism of your valve? Did it fail gradually or suddenly, and what were the symptoms. I know you don’t know the cause of failure, but I’m very interested in what exactly failed in the valve.

  • Liz

    I had a tissue valve in 2007 at the Cleveland clinic in Ohio. the past 2 years I have had a lot of pressure near my diaphragm. I find it painful to wear a bra and it the lower part of my ribs are sore. The pain radiates to my back and I have been taking a lot of a ti inflamatories. Has anyone had this problem? I wondered about scar tissue or where the ribs are wired after replacing the valve. Please write if you know of any possibilities.

  • Ann

    Dear Bill,
    I’m sorry I’m just now replying. I’ve been taking care of my father in the hospital. He does have congestive heart failure, but his porcine valve is still doing great after 8 years. He has had numerous dental procedures, including 2 implants, since his surgery without antibiotics. I really believe it is according to each individual’s immune system. Currently, my titanium implant (implanted after the root-canaled tooth was extracted) is giving me fits and I’m thinking about getting it out. I always insist on antibiotics now.
    Last August I began symptoms of racing heart, fatigue, dizziness, and extremely out of breath for no reason. Actually, I felt better walking around the block than I did just walking across the room. I asked my cardiologist for an early echo. It looked fairly normal, but I was still feeling terrible, so my surgeon ordered a cath. This showed the growth of scar tissue closing my valve. I have the smallest bovine valve available, (19cm) so a transcatheter valve is not an option. I’m sure by the time you need another valve, that will be an option (the smallest transcatheter made I think is 23cm).
    I’m feeling better at the moment, which gives us a little time to decide on my next valve, probably within a few months.
    Best of health to you,
    Ann

  • John Petrick

    Recently, after sonic test of the heart was diagnosed with aortic stenosis(severe around .6). I am 74. I been asked to come in for a stress test in order to determine on the survival curve how long I have before I should have the surgery. I this normal or should I be immediatetly be on the the way to surgery?
    I know I have to have surgery. Other than this diagnosis I feel great. I did have triple bypass 24years ago and also have atrial fibrillation.
    I am a patient of the VA cardiologist group. I have a big concern about cost. Does medicare cover a operation? Is this all taken care of by the VA? I know the costs are out of sight

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